Semancik Christopher S, Whitworth Hilary S, Price Matt A, Yun Heejin, Postler Thomas S, Zaric Marija, Kilianski Andrew, Cooper Christopher L, Kuteesa Monica, Talasila Sandhya, Malkevich Nina, Gupta Swati B, Francis Suzanna C
IAVI, 125 Broad St, New York, NY 10004, USA.
Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA.
Vaccines (Basel). 2024 Dec 11;12(12):1394. doi: 10.3390/vaccines12121394.
: Orthoebolaviruses and orthomarburgviruses are filoviruses that can cause viral hemorrhagic fever and significant morbidity and mortality in humans. The evaluation and deployment of vaccines to prevent and control Ebola and Marburg outbreaks must be informed by an understanding of the transmission and natural history of the causative infections, but little is known about the burden of asymptomatic infection or undiagnosed disease. This systematic review of the published literature examined the seroprevalence of antibodies to orthoebolaviruses and orthomarburgviruses in sub-Saharan Africa. : The review protocol was registered on PROSPERO (ID: CRD42023415358) and previously published. Eighty-seven articles describing 85 studies were included, of which seventy-six measured antibodies to orthoebolaviruses and forty-one measured antibodies to orthomarburgviruses. : The results highlight three central findings that may have implications for vaccine development and deployment. First, substantial antibody seropositivity to Ebola virus (EBOV) and Sudan virus (SUDV) was observed in populations from outbreak-affected areas (≤33% seroprevalence among general populations; ≤41% seroprevalence among healthcare workers and close contacts of disease cases). Second, antibody seropositivity to EBOV, SUDV, and Marburg virus (MARV) was observed among populations from areas without reported outbreaks, with seroprevalence ranging from <1 to 21%. Third, in Central and East Africa, MARV antibody seroprevalence was substantially lower than EBOV or SUDV antibody seroprevalence, even in outbreak-affected areas and in populations at a moderate or high risk of infection (with MARV seroprevalence mostly ranging from 0 to 3%). : Whilst gaps remain in our understanding of the significance of antibody seropositivity in some settings and contexts, these findings may be important in considering target indications for novel filovirus vaccines, in defining study designs and strategies for demonstrating vaccine efficacy or effectiveness, and in planning and evaluating vaccine deployment strategies to prevent and control outbreaks.
正埃博拉病毒属和正马尔堡病毒属是丝状病毒，可导致人类病毒性出血热以及严重的发病和死亡。对预防和控制埃博拉和马尔堡疫情的疫苗进行评估和部署，必须基于对致病性感染的传播和自然史的了解，但对于无症状感染或未确诊疾病的负担知之甚少。这项对已发表文献的系统综述，研究了撒哈拉以南非洲地区针对正埃博拉病毒属和正马尔堡病毒属的抗体血清阳性率。：该综述方案已在国际前瞻性系统评价注册库（注册号：CRD42023415358）上注册并已发表。纳入了描述85项研究的87篇文章，其中76项检测了针对正埃博拉病毒属的抗体，41项检测了针对正马尔堡病毒属的抗体。：结果突出了三个核心发现，可能对疫苗研发和部署具有影响。第一，在疫情影响地区的人群中观察到对埃博拉病毒（EBOV）和苏丹病毒（SUDV）有相当高的抗体血清阳性率（普通人群中血清阳性率≤33%；医护人员和病例密切接触者中血清阳性率≤41%）。第二，在未报告疫情的地区的人群中观察到对EBOV、SUDV和马尔堡病毒（MARV）的抗体血清阳性率，血清阳性率范围从<1%到21%。第三，在中非和东非，即使在疫情影响地区以及感染风险中等或高的人群中，MARV抗体血清阳性率也显著低于EBOV或SUDV抗体血清阳性率（MARV血清阳性率大多在0%至3%之间）。：虽然在某些情况和背景下，我们对抗体血清阳性率的意义的理解仍存在差距，但这些发现对于考虑新型丝状病毒疫苗的目标适应症、确定证明疫苗效力或效果的研究设计和策略，以及规划和评估预防和控制疫情的疫苗部署策略可能很重要。
